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Left ventricular assist device in cardiac amyloidosis: friend or foe?

Carlotta Sciaccaluga1, Giuseppe De Carli2, Chiara Fusi2

  • 1Department of Medical Biotechnologies, Section of Cardiology, University of Siena, Siena, Italy. carlotta.sciaccaluga@gmail.com.

Heart Failure Reviews
|November 30, 2022
PubMed

Insights

Left ventricular assist devices (LVADs) offer a heart transplant alternative for advanced heart failure. This review explores LVAD challenges in cardiac amyloidosis, a condition complicating implantation and management.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Technology

Background:

  • Cardiac amyloidosis is an increasing cause of heart failure, often diagnosed late.
  • Management of advanced heart failure in amyloid cardiomyopathy is critical.
  • Left ventricular assist devices (LVADs) are an alternative to heart transplant for end-stage heart failure.

Purpose of the Study:

  • To review current evidence on LVAD use in cardiac amyloidosis.
  • To highlight challenges associated with LVAD implantation in this patient group.
  • To discuss post-implant management considerations for LVADs in cardiac amyloidosis.

Main Methods:

  • Literature review of studies on LVADs in cardiac amyloidosis.
  • Analysis of anatomical and physiological challenges in LVAD implantation.
  • Examination of systemic complications and management strategies post-LVAD.

Main Results:

  • LVAD implantation in cardiac amyloidosis presents significant anatomical and physiological challenges.
  • Systemic amyloidosis increases risks of bleeding and right ventricular failure after LVAD implant.
  • Limited data exists, necessitating further research into LVAD efficacy and safety in this population.

Conclusions:

  • LVADs are a potential option for advanced heart failure in cardiac amyloidosis.
  • Careful patient selection and specialized management are crucial for successful outcomes.
  • More research is needed to optimize LVAD therapy for cardiac amyloidosis patients.

Keywords:
Cardiac amyloidosisLeft ventricular assist deviceRestrictive cardiomyopathies

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